Mission Hospital targets childhood obesity

Olivewood Elementary School Principal Michael Conlon, pictured here helping defend the goal in a game of soccer with students, has "opened up his campus to any thing that would benefit the kids," said Carla DiCandia, who heads up Mission Hospital's obesity task force. ISAAC ARJONILLA, ORANGE COUNTY REGISTER

Measuring body fat

Each spring while administering the Physical Fitness Test, schools screen the body fat of students in fifth, seventh and ninth grades. Of the test's six fitness areas, the state says the body composition component is the most important indicator of future health problems.

About 95 percent of school districts, including Capistrano Unified and Saddleback Valley Unified, use the Body Mass Index, a number calculated based on weight and height. Depending on how they compare with others of the same sex and age, students are categorized as either very lean, in the "healthy fitness zone," in need of improvement or at-risk.

Children whose BMIs are above the healthy fitness zone are considered overweight. The test's standards are more strict than the Centers for Disease Control and Prevention's guidelines, which are the national standard. Although scientists and health officials agree that BMI is an easy tool, some argue it isn't the most accurate way to measure healthy body weight because it doesn't measure fat directly. Fit, athletic children with little fat might be deemed overweight because bone and muscle are more dense.

Here are the percentages of overweight or obese fifth-graders in south Orange County, according to recently released 2013 California Physical Fitness Test results:

• Boys & Girls Clubs of San Juan Capistrano and Laguna Beach: The clubs host nutrition programs and play with kids at recess.

• Cities of Aliso Viejo and Mission Viejo: Incorporate obesity-prevention strategies into programs and provide free or reduced-price services to residents. They have adopted resolutions and proclamations to support initiatives such as "Walk to School Day."

• Orange County Department of Education: Gave "Instant Recess" DVDs to teachers and will train faculty in targeted schools in 2014.

Source: Carla DiCandia of Mission Hospital

Philadelphia model

In 1999, the home of the Philly cheese steak topped Men's Health Magazine's list of America's fattest cities. Now, Philadelphia is a model for cities seeking to combat obesity. Programs to help residents lose weight have largely targeted school children. From 2006 to 2010, the obesity rate among Philadelphia's K-12 public school students fell 4.8 percent.

Findings from a 2012 study mirrored similar trends in California and New York City, but big dips among certain racial and ethnic groups were unique. There were declines for nearly all ages, genders and minorities, including an 8 percent decrease in obesity rates among black boys and a 7 percent drop among Hispanic girls.

Cited as potential contributors:

• Sugary drinks were removed from school vending machines.

• The city banned trans-fats and implemented a tough menu-labeling law.

• The school district started to offer nutrition education to students from low-income families.

• The city adopted a policy to make bicycling on city streets safer and easier, and sidewalks more pedestrian-friendly.

Still, almost 9 percent of all teenage students were severely obese – a number the study deemed "unacceptably high." In response, the public health department launched a new initiative that has so far led to the establishment of "wellness councils" in 171 schools; food and fitness standards for city-operated afterschool and recreation programs; and a network of 600 corner stores that promote and sell whole grains and low-fat dairy foods.

Sources: Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010; phila.gov/health; planphilly.com

They run in similar circles. Karla Lopez del Rio of NeighborWorks Orange County teaches leadership and organization skills to low- and moderate-income residents. Carla DiCandia works for Mission Hospital and is leading its charge to lower obesity rates in similar populations in some south Orange County communities.

When they met about a year ago, at an event with the Sheriff's Department focused on making a neighborhood known as the Villas in San Juan Capistrano safer, a bell went off. “I was like, ‘Ding, ding, ding! This is a great opportunity to collaborate,'” DiCandia said.

With help from Creer, a nonprofit community organization in San Juan Capistrano, the two women have supported about a dozen mothers as they work to expand and improve a playground in the Villas, a collection of condos west of the train tracks that is home to a large population of Latino families.

“I'm going to have grandkids soon, and I want them to have a better place to play,” Francisca Rodriguez, a 28-year Villas resident, said through a translator.

Mission Hospital is nearing the end of its latest three-year anti-obesity effort. It is organizing and driving parents, community groups, local health-care providers, housing agencies and educators to expand healthy food offerings and exercise opportunities for kids 3 to 11.

“I love what they're doing because it's so grass-roots,” said Chris Corliss, who coordinates health and physical education programs for the Orange County Department of Education.

Along with the Fullerton Collaborative and Activate Anaheim, Mission Hospital's effort is one of the most comprehensive anti-obesity projects in the county, Corliss said. Campaigns started emerging in the past five years, as more research was conducted on the relationship between healthy children and learning, he said.

“All of this research data is telling us (that) when we invest in programming and services that help improve health and fitness, we see an immediate impact on learning behavior in the classroom,” Corliss said.

To varying degrees, the Catholic hospital in Mission Viejo and its partners are helping six schools in San Clemente, San Juan Capistrano and Lake Forest – cities it identified as having pockets of “high need.” That includes areas where residents have low literacy rates, lower incomes and education and “other things that we know ultimately affect peoples' health,” DiCandia said.

The group also has begun working with two Mission Viejo schools that some students from the Villas and Lake Forest attend.

When the project launched in 2011, DiCandia calculated the average body mass indexes of fifth-graders in Capistrano Unified and Saddleback Valley Unified school district schools with high percentages of students eligible for federal food subsidies. The result: 41.6 percent were overweight or obese.

The finding was distressing, but not surprising, DiCandia said.

“We actually see 5-year-old children who weigh over 130 pounds,” she said. “It's really very sad that kids won't, or can't, rather, in some neighborhoods, go out to play, that it's cheaper and easier for families to buy fast food, that parents aren't enforcing good eating habits at home. There are so many contributing factors.”

Historically, according to the Centers for Disease Control, obesity is more prevalent among blacks and Latinos, and is less likely in families where the head of the household has a college degree. The prevalence of obesity also grows as family income decreases, although the majority of obese children are actually from families that are not low-income, which by government standards means they are not eligible for free school meals.

In the eight schools with which the hospital is working, the number of students eligible for free meals ranged from 37 percent to 94 percent in 2012. To qualify, families of four had to earn $29,064 or less before taxes.

Olivewood Elementary School Principal Michael Conlon, pictured here helping defend the goal in a game of soccer with students, has "opened up his campus to any thing that would benefit the kids," said Carla DiCandia, who heads up Mission Hospital's obesity task force. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
From left: Jade Ryan Reyes, 8, Jose Roda, 8, and Jesus Martinez Ramos, 8, chase a ball as they run across the soccer field at Olivewood Elementary School in Lake Forest. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
Summer Mejia, 22, a youth development professional with the Boys and Girls Club of Laguna Beach, helps second grader Dallas Rush, 8, put on a red jersey before he runs off to play with the rest of his classmates. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
Dozens of second and third grade students from Olivewood Elementary School run towards the soccer goal. Mission Hospital is in the midst of a three-year plan to reduce the obesity rates of low-income children in south Orange County; Olivewood in Lake Forest has embraced the hospital's efforts. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
About 50 second and third graders partook in lunchtime playtime activities led by the Laguna Beach Boys and Girls Club. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
Jose Brito Salinas, 8, passes the ball downfield to a teammate during his lunch break at Olivewood Elementary School. In partnership with Mission Hospital and the Boys and Girls Club of Laguna Beach, Olivewood is trying to reduce its students obesity rates, in part by keeping them active at recess. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
Olivewood Elementary School students chase after the soccer ball and try to score while Principal Michael Conlon jogs next to them. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
Erik Vasquez, 22, with the Boys and Girls Club of Laguna Beach runs alongside Jose Brito Salinas, 8. The club has partnered with Olivewood and Mission Hospita's obesity task force to try to reduce obesity rates among low-income children in south Orange County. ISAAC ARJONILLA, ORANGE COUNTY REGISTER
As he runs back to class at the end of lunch recess, Jose Brito Salinas, 8, smiles, because his team won the game. ISAAC ARJONILLA, ORANGE COUNTY REGISTER

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